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Offline Miss Beams

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ACL giving way
« on: November 07, 2010, 12:21:37 PM »
i have posted various questions on this site over the last few weeks, however, i was just wondering what ACL experiences people have had when their ACL 'gives way'?  I have experienced a few times, as well as the usual leg locking and feeling wobbly like its going to buckle, but i have also had occasions where my leg seems to slip from underneath me?  is this a type of instability that also occurs with the ACL liagament? ??? ???
06/10  L knee trauma(horseriding accident) MCL
10/10 MRI ACL/MCL/G4CM/PF
12.01.2011 scope ACL intact, chronoplasty and 2 x microfractures FMC and trochlear ,MRI over reported(knee not as bad as made out),   time and patience will tell:)

Offline emergRN

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Re: ACL giving way
« Reply #1 on: November 07, 2010, 03:36:05 PM »
I had my ACL torn for a long time before I had reconstruction done.  Sometimes if I just moved the wrong way, it would give out.  It felt like it was sliding out more so than giving out, but I would drop like a stone.  If I was skiing, and my quads were tired, it would feel as if my thigh was not attached to the bottom part of my leg.  It would become very unstable and wobbly.  I never had locking.  Do you have any meniscus tears??
Rt.knee scope-1990-91Dx with Partial ACL tear
Rt. ACLr with hamstring graft-2010
Rt. knee scope- partial lateral menisectomy and plica excision 2010
ACL revision quad tendon graft- 2011 
Rt. Knee partial lateral menisectomy, debridement 2012
Rt. knee partial lateral menisectiomy, debridement 2014

Offline kaseri

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Re: ACL giving way
« Reply #2 on: November 07, 2010, 04:04:00 PM »
When I tore my ACL I did not experience the usual symptoms. I did not hear or feel a "pop" but I did feel lots of pain. In the months following the initial tear I did not experience any instability or "giving out". I had lots of swelling and pain but my knee seemed to function somewhat normally. I'm an alpine mountaineer so having an ACL is very important in my sport so I did have reconstructive surgery and now it feels better than my "good knee".

Offline Miss Beams

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Re: ACL giving way
« Reply #3 on: November 07, 2010, 05:12:30 PM »
no meniscus tears apparently but loads of arthritis too, so knee is often very stiff and clickly at the back like a rubberband twanging when i stretch my leg out, but it has just recently slipped from underneath me although this has happened on slippy ground but prior to this i would be able to stabalise myself.  i unfortunately am not a skier or play football, just a horse-rider with horses at home so there a lot of paddock maintainence etc to do which doesnt help with the burden of a dodgy knee with lack of acl! :'(
06/10  L knee trauma(horseriding accident) MCL
10/10 MRI ACL/MCL/G4CM/PF
12.01.2011 scope ACL intact, chronoplasty and 2 x microfractures FMC and trochlear ,MRI over reported(knee not as bad as made out),   time and patience will tell:)

Offline Snowy

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Re: ACL giving way
« Reply #4 on: November 08, 2010, 03:41:11 PM »
This sounds pretty typical of an ACL deficient knee. My ACL was partially torn four years ago, and finally ruptured completely this March. After the partial tear, I experienced a lot of incidents of the knee giving way - sometimes it would slip, sometimes it would buckle completely. In the early days it actually dumped me on the ground a few times when this happened. Interestingly I didn't experience any buckling or instability following the complete tear. The main difference was that I wasn't in very good shape when the partial tear happened, and my leg muscles weren't in good condition; in contrast, when I had the full tear I'd been skiing and cycling like mad and my quads were in the best shape of my life.

I'm not sure if you're working with a physiotherapist at the moment, but they should be able to give you targeted exercises to build up your muscles and help provide support for the joint. (There's also some great information about ACL prehab and rehab exercises over on the Information Hub.)

Are you planning to have it reconstructed?
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline Miss Beams

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Re: ACL giving way
« Reply #5 on: November 08, 2010, 09:10:47 PM »
i have been having physio, but its the NHS which isnt brilliant, you are given a list of exercises and thats it!  however, i am being referred to a fitness centre 'prescription for exercise' apparently i will have a fitness instructor who will help with the leg strengthening stuff.  I have been swimming and doing the exercises to help myself.  The first OS has said no to ACLr as he felt i didnt need it and could manage! however, he has referred me on to another OS who is a soft tissue expert and i have an appt in Dec.  I think this is apparently to discuss the options and a TKR at some point but maybe considered  as too young!!!!  Hay ho!
Thank you for your reply. 
06/10  L knee trauma(horseriding accident) MCL
10/10 MRI ACL/MCL/G4CM/PF
12.01.2011 scope ACL intact, chronoplasty and 2 x microfractures FMC and trochlear ,MRI over reported(knee not as bad as made out),   time and patience will tell:)

Offline kscope09

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Re: ACL giving way
« Reply #6 on: November 08, 2010, 10:46:17 PM »
I had my injury in Feb 2008 and my surgery in August 2009 which was an exploratory scope.  The surgeon found that I had a small tear in my acl which really surprised me because I hadn't had any of the usual acl related symptoms.  My knee was painful and annoying but it wasn't unstable.  After the scope when my quads were like jelly I did experience some feeling of giving way, though I've never fallen.  I've had a few people do lachman's on me and some have said they can tell there is an acl problem and others say that if I hadn't mentioned it already they would never have known.  One physio said that he'd noticed the laxity decrease while I'd been seeing him and my latest physio say's that while it is lax it is within normal limits.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Snowy

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Re: ACL giving way
« Reply #7 on: November 09, 2010, 04:50:31 AM »
Hmmm - I'd be a bit sceptical about being told that you don't need an ACLr at this stage. Until you've been through a proper strengthening program, there's no way of knowing whether you'll be able to strengthen the muscles enough to provide proper support for the joint. There's a rule of thirds on this - a third of people can cope without an ACL after a strengthening program; a third can cope provided they stay away from all risky activities; and a third never manage to stabilize the joint enough to prevent buckling. And even if you're in the first group, the knee still lacks the lateral support provided by an intact ACL and you'll always be at risk of further damage and arthritis. (That's why I opted for a reconstruction even though my knee was 100% stable.) It's good that you have a referral to a second OS; it might be an idea to prepare a list of questions about the possible consequences of living without an ACL, and specifically the kinds of activities you need to be able to do.

I had some bad experiences with NHS physiotherapists when I was living in the UK, so you have my sympathy. It may be worth paying for a couple of private physio appointments if you can. Targeted PT is so, so important, especially if you are planning to live without an ACL. I also found the cruciate rehabilitation section of the information hub invaluable - having been through prehab and rehab with a superb physiotherapist here in Canada, I could almost have designed my own program with this very detailed course:

http://www.kneeguru.co.uk/KNEEnotes/node/775

Do you have significant cartilage loss as well as the ACL tear? I'm not sure why TKR would be in the cards otherwise...
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline kscope09

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Re: ACL giving way
« Reply #8 on: November 09, 2010, 10:13:05 AM »
Can someone who has had an acl tear have a TKR?  When someone has a TKR what do they do with the ligaments, do you get metal ones?
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Miss Beams

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Re: ACL giving way
« Reply #9 on: November 09, 2010, 09:16:09 PM »
reply to the first question, i apparently have grade 4 arthritis so guess that is where the TKR comes in??  and i guess they would remove the ruptured ligament if they did a TKR?????? all very baffling to me, just want my knee better.

06/10  L knee trauma(horseriding accident) MCL
10/10 MRI ACL/MCL/G4CM/PF
12.01.2011 scope ACL intact, chronoplasty and 2 x microfractures FMC and trochlear ,MRI over reported(knee not as bad as made out),   time and patience will tell:)

Offline Snowy

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Re: ACL giving way
« Reply #10 on: November 11, 2010, 06:46:21 AM »
That would definitely explain the TKR. Sorry to hear that; it's a pretty rough diagnosis.

Regarding your question about ligaments and TKR, that's a really interesting one. I've been doing some digging around and it looks as though they preserve the collateral ligaments in a TKR, but both the ACL and PCL can be either retained or sacrificed depending on the kind of TKR that takes place. (It sounds as though it's more normal to sacrifice the cruciate ligaments, especially the ACL.) With regard to the ACL, I found this article that might be of interest:

http://www.orthosupersite.com/view.aspx?rid=23134

Essentially the research found that the stability provided by an ACL is essential for the knee to function normally; however, there are replacement knees (the bicruciate-substituting TKR) that can provide a similar level of support and stability to a TKR that retains the ACL.

This was just a quick search; as someone who is almost certainly headed for TKR in the future (I was diagnosed with OA in my left knee at 28, and right knee at 33) I'm actually very curious to find out more, especially having gone through an ACLr this year.
« Last Edit: November 11, 2010, 06:54:32 AM by Snowy »
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline Miss Beams

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Re: ACL giving way
« Reply #11 on: November 11, 2010, 07:31:52 AM »
thank you for your reply, you have also had a lot of knee injury too, i was just wondering before you had your ACLr, were you able to fully straighten from knee to ankle, i find i have resistance to getting it fully straight.  It will be interesting when i speak to the knee specialist regarding whether i have a complete tear, whether my PCL is intact as this was the only ligament not mentioned on the MRI report.  I hate these waits between consultations as you mind starts working overtime which is not good.  Some days my feels reasonable then I move wrong and then i remember! :(
06/10  L knee trauma(horseriding accident) MCL
10/10 MRI ACL/MCL/G4CM/PF
12.01.2011 scope ACL intact, chronoplasty and 2 x microfractures FMC and trochlear ,MRI over reported(knee not as bad as made out),   time and patience will tell:)

Offline Audice

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Re: ACL giving way
« Reply #12 on: November 11, 2010, 11:27:12 AM »
Miss Beams wrote:  i was just wondering before you had your ACLr, were you able to fully straighten from knee to ankle, i find i have resistance to getting it fully straight. 

Interesting question to me because for a good 4 years after I damaged my knee I was unable to completely straighten it. Despite riding my horse & working at the farm over all sorts of terrain on a regular basis, that knee would never line up with the other one.

Being 72 I wasn't offered ACLr so became intent on getting along w/o the ligament - which I think I do quite nicely. Oh, yes, I'm aware of what can happen if I put myself in a compromising position like pivoting or even turning too quickly. The only time my knee is unreliable is when one of my dogs slams into me & then I do go down but it wouldn't surprise me to find if I had two good knees the same fall would occur. Just recently I notice that when I stand, both knees are lined up as they should be. I haven't a clue why all of a sudden that knee straightens as it should but I'm pleased it's finally happened.
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline Miss Beams

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Re: ACL giving way
« Reply #13 on: November 11, 2010, 01:20:42 PM »
thats interesting, i find my problems are when i am beavering away at home with the horses doing yard duties.  Especially walking on uneven ground.  I have just started strengthening exercises at the local gym which i think will be beneficial to both my knees!
06/10  L knee trauma(horseriding accident) MCL
10/10 MRI ACL/MCL/G4CM/PF
12.01.2011 scope ACL intact, chronoplasty and 2 x microfractures FMC and trochlear ,MRI over reported(knee not as bad as made out),   time and patience will tell:)

Offline Snowy

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Re: ACL giving way
« Reply #14 on: November 11, 2010, 05:42:21 PM »
I did manage to straighten my leg fully before surgery, but it took a long time - for at least two or three months after injury I couldn't. The exercise that finally got my leg straight again was the terminal knee extension:

http://www.kneeguru.co.uk/KNEEnotes/node/783 (second one down)

I started doing 100 of these each day, and the last few degrees that I'd been missing came back really quickly. It's a handy exercise because all you need is a piece of theraband and something like a table leg - you can do it anywhere.

If your PCL wasn't mentioned on the MRI, I'm guessing it's okay - fingers crossed.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA